This World Diabetes Day on 14 November, the Baker Heart and Diabetes Institute is addressing the impact of diabetes on global health. As well as conducting world-leading research in Australia, the Baker Institute is working in close collaboration with Indian health services to reduce type 2 diabetes and heart disease risks among young people living in tribal villages in northeastern India. Through the development of community-led lifestyle programs, we're addressing the rising tide of life-threatening conditions that disproportionately affect under-resourced rural and tribal communities. India has the second-highest number of adults with diabetes in the world.
India is home to an estimated 101 million people with type 2 diabetes, along with approximately 136 million people who are prediabetic and therefore at elevated risk of developing diabetes in the near future. Alarmingly, more than half of those affected remain undiagnosed, increasing the likelihood of preventable complications due to delayed detection and management.
Cardiovascular health presents an equally urgent challenge. More than 315 million adults have high blood pressure1, forcing their hearts to work harder every day.
To address these life-threatening health issues, the SHILLONG Project is about to recruit over 1300 young people aged 15 to 24 from across 40 villages scattered through the mountainous terrain in Meghalaya state, northeastern India. Across recent generations, these tribal communities have experienced dramatic lifestyle and dietary shifts, including increases in risky behaviours such as physical inactivity, unhealthy diets, tobacco use, and harmful alcohol consumption. By adapting evidence-based strategies tailored to the unique culture of tribal communities, we will empower young people to build sustainable and healthy lifestyle habits that greatly reduce their long-term cardiometabolic disease risks.
Kai Wallens from Prof Brian Oldenburg's Non-Communicable Diseases and Implementation Science lab at the Baker Institute, recently travelled to northeastern India to visit remote communities and attend a stakeholder workshop. This marked an important milestone in the project. With 85 attendees, the workshop brought together community voices to help shape the project strategies and resources for the 18-month lifestyle intervention program.
During the workshop, the team explored how to tackle the biggest risk factors for young people's health — boosting physical activity, and improving access to healthy foods, health services and health education. We also covered how to build trust in healthcare professionals where many rely on traditional remedies from local healers.
Kai says, "We are shining a light on diabetes and heart health, and showing how to change behaviours to reduce the future risks. We're also fostering a sense of autonomy for young people to make their own decisions about their health in a positive sense, and not just consider the most convenient options. Together, we have begun on a path to buck the current trend. Our hope is that these young people become peer leaders and mentors for the next generation — helping to transform their futures too."
Our peer-led lifestyle program can empower communities to take charge of their health. Our goal is clear - to collaborate on solutions that integrate community and clinical care, and scale up proven programs to transform cardiometabolic health in India's remote communities.
The SHILLONG Project has evolved from the successful Kerala Diabetes Prevention Program that Prof Oldenburg from the Baker Institute led. It was the first well-evaluated community-based, peer-led diabetes prevention program in India. This was adapted from evidence-based lifestyle interventions implemented in Finland, the United States and Australia.
The Baker Heart and Diabetes Institute is leading the SHILLONG Project in partnership with the Christian Medical College Vellore and Dr H Gordon Roberts Hospital in Shillong.
